Brain stimulation is not only an important means for the treatment of drug resistant epilepsy， but also the most promising way of neuromodulation. At present，only deep brain stimulation of anterior nucleus of thalamus and responsive neural stimulationare commonly used in clinic. However，some other stimulation methods such as deep brain stimulation including subthalamic nucleus，centromedian thalamic nucleus，hippocampus⁃amyg⁃ dala and other targets，together with different forms of closed ⁃loop neuromodulation and chronic subthreshold cortical stimulation also show good clinical efficacy and application prospects. These stimulation methods are worthy of in⁃depth study and are necessary to be transformed into effective clinical treatment as soon as possible. To deeply reveal the mechanism of different stimulation regulation is the premise of the selection of appropriate candidate， appropriate stimulation targets and optimal stimulation mode in patients with refractory epilepsy. It is also an effective way to improve the clinical efficacy of brain stimulation in the treatment of refractory epilepsy. Additionally，these aspects are also the direction of further research.

Enhanced recovery after surgery（ERAS）is a term often used to describe evidence⁃based peri⁃ operative care programs. Through the cooperation of department of surgery，anesthesisology，nursing，and nutrition and other departments，the perioperative protocol is optimized so as to reduce postoperative complications，shorten hospital stay and enhance the recovery of patients after surgery. With the extensively accepted concept and proto⁃ cols of ERAS in the past decade，the insufficient supply of medical resources in China has been alleviated. Effec⁃ tive analgesia is an important element of ERAS and preventive，multimodal，opioid⁃sparing analgesia and individu⁃ alized analgesia is effective for improving patient′s quality of life and satisfaction. This article summarizes the post⁃ operative analgesia strategies under the concept of ERAS.

Postoperative cognitive dysfunction（POCD）is a complication after surgery，with main manifes⁃ tations of mental disorder，anxiety，personality changes and memory impairment. But the exact pathogenesis of POCD is not clear. At present，it is considered that central neuro⁃inflammation，oxidative stress and apoptosis are the main causes of POCD. Noncoding RNA（ncRNA）is a kind of gene transcripts that does not have protein coding function but regulate gene transcription and translation，mainly including microRNA，long noncoding RNA and circular RNA. In recent years，studies have found that noncoding RNA is widely involved in the pathogenesis of POCD. In this review，we have summarized the research progress of noncoding RNA in the pathogenesis of postop⁃ erative cognitive dysfunction，in order to provide new ideas for the prevention and treatment of POCD. 

Objective To investigate the mechanism ofaction ofmiR⁃216a on acute kidney injury in septic ratsvia NF⁃κB signaling pathway. Methods Forty SD rats were selected，and a rat model was established by cecal ligation and puncture. The rates were randomly divided into asham⁃operation group，model group，miR⁃NC group， and miR⁃216a group，10 for each group. The pathologicalchangesin thekidneys were observed. RT⁃PCR was used to detect expression of miR⁃216a in the ratkidney tissues in each group；serum levels of biochemical indexes were detected by automatic biochemical analyzer；levels of inflammatory factors in each group were detected by ELISA； and expression of murine NF ⁃ κB pathway ⁃ related protein was detected by WB. Results In the sham ⁃operation group，no abnormal kidney tissue structure developed；in the model and the miR ⁃NC groups，the kidney tissues wereaccompanied by inflammatory infiltration and widened interstitium；andin the miR⁃216a group，inflammatory infiltration and glomerular lesions were alleviated. As compared with the sham⁃operationgroup，expression levels of miR⁃216a inthe kidney tissues were lower in the model group andthemiR⁃NC group，and as compared with the miR⁃NC group，expression levels of miR⁃216a inthe kidney tissue were higher in the miR⁃216a group.As compared with the sham⁃operationgroup，serum levels of Scr，BUN and KIM⁃1 were higher in the model group and the miR⁃NC group while lower in the miR⁃216a groupascompared with the miR⁃NC group（P < 0.05）. As compared to the sham⁃ operation group，serum levels of TNF⁃α，IL⁃6，and IL⁃1β were higher in the model groupand miR⁃NC group，but⁃ lower in themiR ⁃ 216a group ascompared to miR ⁃ NC group（P < 0.05）. In comparison withthe sham ⁃ operation group，expressions of NF⁃κB p65，p⁃NF⁃κB and p65 were higher inthemodel groupand miR⁃NC group，while thoseexpressionswerelower in the miR⁃216a groupthan in the miR⁃NC group（P < 0.05）. Conclusions miR⁃216a over⁃ expression reduced inflammation levels and ameliorated renal injury in septic rats，possibly through regulation of the NF⁃κB signaling pathway.

Objective To investigate the role and molecular mechanism of E2F7 in papillary thyroid carcinoma（PTC）. Methods The correlation between E2F7 and TC was predicted by bioinformatics analysis. The expression of E2F7 in PTC and adjacent tissues was detected by immunohistochemistry. Western blotting（WB） was used to detect the expression level of E2F7 in human PTC K1，TPC⁃1 and BCPAP cell lines and in normal human thyroid Nthy⁃ori3⁃1 cell line. The effect of silencing E2F7 on the proliferation and migration of K1 cells was detected by growth curve，clone formation assay and scratch assay. Flow cytometry was used to detect the effect of silencing E2F7 on K1 cell cycle and apoptosis. The transcription of cyclin cyclinD1，cyclinE1，EIF4A3 and cyclin⁃dependent kinase 4（CDK4）genes was detected by qRT⁃PCR，and the effect of E2F7 on cyclin and pathway proteins Akt，pAkt by WB. Results The expression level of E2F7 in PTC tissues is higher than that in adjacent tissues，clinical stage and lymph node metastasis were statistically significant with E2F7 expression level；The expression of E2F7 in K1 cells is significantly higher than that in normal thyroid cells；the protein expression level of K1 cells in the E2F7 silence group is compared with that in the control group compared with the control group； The proliferation and migration abilities were inhibited in the E2F7 silence group；The transcription and translation levels of cyclins in the E2F7 silence group were lower than the control group；The expression levels of key pathway proteins Akt and pAkt were down ⁃ regulated compared with the control group；The cycle progression was blocked and the rate of apoptosis increased. Conclusions The high expression of E2F7 in PTC tissue is related to the occurrence and development of PTC；E2F7 silencing causes K1 cell cycle arrest，promotes apoptosis and inhibits proliferation through Akt signaling pathway.

Objective To observe the effects of icariin on coagulation function，inflammatory factors and fibrinolytic system in rats with venous thrombosis，and to further clarify its mechanism. Methods 54 rats were randomly divided into 5 groups：sham operation group（n = 10），thrombus group（n = 14），low⁃dose icariin group （n = 10），medium⁃dose icariin group（n = 10），and high⁃dose icariin group（n = 10）. Each drug group was intra⁃ venously injected with icariin solution of 10，20，40 mg/kg，respectively. The time points of administration were 1，24，48，72 h after modeling. Thrombus weight，plasma coagulation function indexes，fibrinolytic system indexes， inflammatory factor concentration，and mRNA and protein expressions of NF⁃κB P65，VCAM⁃1 and TF in venous and vascular tissues of rats were detected 1 h after the last administration. Results Compared with the thrombus group，different doses of ICariin group decreased thrombus weight（P < 0.05），plasma d⁃dimer，plasminogen activator inhibitor⁃1，interleukin 1β and tumor necrosis factor α concentrations（P < 0.05）. The mRNA and protein expressions of NF⁃κB P65，VCAM⁃1 and TF in venous tissues were decreased with the increase of plasma partial thrombin time，prothrombin time，thrombin time and tissue plasminogen activator concentration（P < 0.05），and the effect was more obvious with the increase of dose. Conclusion Icariin can inhibit venous thrombosis by improving coagulation parameters，fibrinolytic system parameters and inflammatory response，and this effect may be related to the regulation of NF⁃κB P65 signaling pathway. 

Objective To investigate the expression of circAAS1 in preeclampsia and its effect on invasion and migration of placental trophoblast cells. Methods qRT⁃PCR was used to detect the expression of circAAS1 in placental tissues of 30 cases of preeclampsia（preeclampsia group）and 30 cases of controls（control group）， followed by analyzing the correlation between circAAS1 expression and the clinical indications of the preeclampsia group. The effects of interference and overexpression of circAAS1 on invasion and migration of human chorionic trophoblast cells（HTR8/SVneo cells）were investigated by Transwell and scratch assay. The software of StarBase was used to predict downstream targets of circAAS1 and analyze its expression in placental tissues. Finally，the effect of circAAS1 on miR⁃15a⁃5p expression in the trophoblast cells was detected by qRT⁃PCR. Results Different from the results of the control group，the circAAS1 expression was up ⁃ regulated in the placental tissues of pre⁃ eclampsia group（P < 0.01）and it was positively correlated with clinical indications（P < 0.01）. The up⁃regulated circAAS1 inhibited the invasion and migration of trophoblast cells（P < 0.05）so that miR ⁃15a ⁃5p expression was down ⁃ regulated（P < 0.01）. Interference with the circAAS1 expression had the opposite effect（P < 0.05）. Conclusion circAAS1 is highly expressed in placental tissues of preeclampsia and it is correlated with systolic and diastolic blood pressure. CircAAS1 inhibits trophoblast behavior by regulating miR ⁃ 15a ⁃5p level，suggesting that circAAS1 may play an important role in trophoblast occurrence，early diagnosis and treatment.

Objective To investigate the effects of ultrasound ⁃ excited basic fibroblast growth factor （bFGF）nano⁃microbubble targeted therapy on keloids and phosphatase and tensin homolog deleted on chromosome ten（PTEN）/phosphatidylinositol 3⁃kinase（PI3K）/protein kinase B（Akt）pathway. Methods A nude mouse keloid model was constructed. The nude mice were divided into acontrol group，bFGF aqueous solution group，bFGF nano⁃ microbubble group，ultrasonic cavitation group，ultrasound plusbFGF aqueous solution group，and ultrasound plusbFGF nano⁃microbubble group. The survival status of nude mice and the growth of keloids were observed，and the volume and weight of keloids were measured. Blood was withdrawn the next day after the last administration， and serum levels of tumor necrosis factor α（TNF⁃α）and transforming growth factor⁃ β（TGF⁃β）in nude mice were detected；the morphology of keloids in nude mice was observed；the apoptosis in keloid tissue was detected； levels of protein caspase⁃3，α⁃SMA，collagen I，PTEN，PI3K，and Akt in keloid tissues were detected by Western blotting（WB）. Results The volume and weight of keloids，serum TNF⁃αand TGF⁃β levels，protein α⁃SMA， collagen I，PI3K，and Akt were lower in each bFGF treatment group thanin the control group，whilethe apoptosis count，protein caspase⁃3，andPTEN expression were higher（P < 0.05）. The volume and weight of keloids，serum TNF ⁃ αand TGF ⁃ β levels，protein α ⁃ SMA，collagen I，PI3K，and Akt were lower in the ultrasound plusbFGF aqueous solution group and ultrasoundplusbFGF nano⁃microbubble group than in the bFGF aqueous solution group and bFGF nano⁃microbubble group，but the apoptosis count，protein caspase⁃3，and PTEN expression were higher （P < 0.05）. Ultrasoundplus bFGF nano ⁃microbubbles was stronger than ultrasound plusbFGF aqueous solutioninsuppression of keloids（P < 0.05）. Conclusions Ultrasound ⁃ excitedbFGF nano ⁃microbubbles can inhibit the growthof keloids，which may be related to the activation of the PTEN/PI3K/Akt pathway.

Objective Patients with rheumatoid arthritis（RA）are immunocompromised and prone to latent tuberculosis infection（LTBI）. The diagnosis and treatment of LTBI are the key to eliminate TB. This study aims to investigate the risk factors of LTBI in patients with RA and provide the basis for clinical anti⁃tuberculosis prevention and treatment. Methods A total of 165 cases of RA with active tuberculosis were investigated retro⁃ spectively，including 59 cases in LTBI group and 106 cases in control group. Clinical data were collected，includ⁃ ing age，sex，disease duration，immunosuppressive therapy，smoking history，and laboratory routine parameters， and univariate and binary logistic regression were used to analyze the factors affecting LTBI in RA patients. Results Among 165 RA patients，the incidence of LTBI was higher in patients aged > 40 years（41.9%）than in patients aged ≤ 40 years（25.0%）. Complement C3，C4 levels，and monocyte count in the LTBI group were higher than those in the control group，and the differences were statistically significant（P < 0.05）；Among 165 RA patients，only 80 patients were tested for lymphocyte immune function，and CD4+ /CD8+ and NK cell counts in the LTBI group were significantly higher than those in the control group（P < 0.05）. Binary logistic regression analysis showed that complement C4，age（> 40 years），and monocyte count had a statistically significant effect on the probability of LTBI in patients with RA（P < 0.05）. Conclusion Complement C4 level，monocyte count and age （> 40 years）are independent risk factors of LTBI in RA patients. The older the age（> 40 years），the higher the complement C4 and monocyte count，the greater the risk of lLTBI.

Objective To analyze the influencing factors and correlation of oral hygiene and stroke⁃associ⁃ ated pneumonia（SAP）in patients with acute ischemic stroke. Methods We performed a cross⁃sectional study by recruiting 331 patients with acute ischemic strokefrom two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. Univariate analyses were performed firstly on the conditions of oral hygiene and occurrence of SAP. Multiple logistic regression analyses were conducted to find risk factors of oral cleanness and SAP in the stroke patients. Results After adjusting the confounders，multivariable logistic regression analysis showed that SAP（OR = 2.219，P = 0.026），dental caries（OR = 1.292，P = 0.005）and age（OR = 1.030，P = 0.006）were the risk factors for oral cleanness in those stroke patients，while the score of Barthel index（OR = 0.986，P = 0.019）was a protective factor. BOAS score（OR = 1.972，P < 0.001）and NIHSS score（OR = 1.322，P < 0.001）were the risk factors for SAP. Conclusion The abnormality of oral cleanness and SAP are the and mutually acting risk factors in patients with acute ischemic stroke. Protecting oral hygiene may be helpful for SAP prevention.

目的 检测四分子交联体蛋白 5（Tspan⁃5）在母⁃胎界面中的表达情况，探讨该蛋白在胚胎种 植中的作用，分析其与自然流产的相关性。方法 观察组选择 2018 年 1 月至 2020 年 1 月就诊于广东省第 二人民医院的稽留流产患者 37 例。对照组选取年龄和孕周相匹配的正常早孕患者及未妊娠育龄期女 性。应用免疫组化法检测 Tspan⁃5 在绒毛、蜕膜及子宫内膜中的表达情况。结果 Tspan⁃5 在自然流产绒 毛中表达水平显著低于正常早孕组，在自然流产蜕膜中表达水平却高于正常早孕组。Tspan⁃5 在未妊娠月 经期子宫内膜未见表达，而增生期、分泌期子宫内膜基质细胞和腺上皮细胞可见表达；正常早孕蜕膜中 Tspan⁃5 表达水平略高于增殖期、分泌期子宫内膜，但差异无统计学意义（F = 1.26，P = 0.296）。结论 Tspan⁃5 在自然流产绒毛中表达水平下降，滋养细胞侵袭不足可能与自然流产的发生有关。母胎界面中 Tspan⁃5表达异常与胚胎种植失败或妊娠丢失相关。

Objective To explore the influence of obesity and bad living habits on the progression of liver fibrosis in metabolic associated fatty liver disease. Methods Patients undergoing FibroTouch in the Affiliated Hospital of Yunnan University from July 2017 to July 2018 were selected for cross⁃sectional analysis. According to the controlled attenuation parameters detected by FibroTouch，the patients were divided into healthy control group （n = 1731）and MAFLD group（n = 410），then according to the liver hardness value detected by FibroTouch， MAFLD group was divided into no or mild liver fibrosis group（n = 262）and progressive liver fibrosis group （n = 148）. Chi ⁃square test，Spearman correlation analysis and binary Logistic regression were used to analyze the influence of bad living habits on the progression of liver fibrosis. Results Statistically significant differences in gender，LSM and BMI were found between healthy control group and MAFLD group（P < 0.05）. There were significant correlations among age，LSM，BMI and CAP in MAFLD group（P < 0.001）. There were statistically significant differences in age，LSM，BMI，CAP and bad living habits between the group without or mild liver fibrosis and the group with advanced liver fibrosis （P < 0.05）. Binary Logistic regression analysis showed BMI and bad living habits were independent risk factors for progression of liver fibrosis in MAFLD（P < 0.05）. Conclusion Risk factors such as obesity and bad living habits increased the risk of liver fibrosis progression in patients with MAFLD.

Objective To investigate the clinical effect of gradient step⁃by⁃step balloon dilatation guided by digital subtraction angiography（DSA）for anastomotic stricture after esophageal cancer surgery. Methods The clinical data of 69 patients with anastomotic stricture after esophageal cancer surgery who underwent DSA guided gradient step⁃by⁃step balloon dilatation from February 2015 to May 2020 in our hospital were retrospectively analyzed. According to the size of anastomotic stoma before and after dilatation，dysphagia grade and quality of life score were assessed. Results DSA guided gradient step⁃by⁃step balloon dilatation effectively improved dysphagia symptoms in patients with anastomotic stricture after esophageal cancer surgery. No statistical significance was found in surgical methods and anastomotic dilatation effect（P > 0.05）；the dilatation effect of balloon dilatation and esophageal cancer surgery within 12 weeks was better than that within 12 weeks（P < 0.05）；the effect of the first two balloon dilatation time within 2 weeks was better than that at more than 2 weeks（P < 0.05）；the quality of life score of patients with more than two dilations was higher than that of patients with only two dilations（P < 0.05）. Conclusion For anastomotic stricture after esophageal cancer surgery，DSA guided gradient step⁃by⁃step balloon dilatation had obvious advantages. Progressive dilatation could be performed by gradient pressure method during operation. The most appropriate dilatation endpoint could be selected. Balloon dilatation within 12 weeks after operation and the second balloon dilatation within 2 weeks after interval improved the dilatation effect of anastomotic stoma. Appropriate increase of dilatation times could improve the quality of life score of patients.

Objective The distribution of non ⁃tuberculous mycobacteria（NTM）and the changes in the status of NTM lung disease（NTM⁃PD）in Guangzhou were analyzed in order to provide a reference for the preven⁃ tion and treatment of NTM⁃PD. Methods Specimens of positive cultures of mycobacteria such as sputum，bronchial irrigation fluid，pus，urine，serous effusion，cerebrospinal fluid and puncture in inpatient and outpatient patients of Guangzhou Chest Hospital from 2018 to 2021 were collected，and 18 501 strains of culture⁃positive Mycobacterium strains were identified by 16S rRNA gene sequencing method. Different characteristics such as NTM strain source， strain distribution，sex，age and so on were analyzed. The results were statistically analyzed using SPSS 23.0 statis⁃ tics software. The comparison of the rates was measured by x2，and the difference between P < 0.05 was statistically significant. Results From 2018 to 2021，a total of 18 501 strains of mycobacteria positive in various specimens were identified by gene chip method，and the NTM detection rate was 35.45%（6 558/18 501），of which the total detection rate of sputum and bronchial irrigation solution was 36.67%（6 426/17 522）；6 558 strains of NTM （calculated by annual elimination of repeated cases）came from 4 336 patients，and the NTM isolation rates were 28.01%，29.04%，respectively. 29.63%，31.68%；The total number of cases in the four years（deleting inter⁃ annual recurrence）was 3 624，the isolation rate of NTM infected patients was 27.98%（3 624/12 950）；the distri⁃bution of the top 5 species was：MAC 1305 cases（36.01%），turtle ⁃abscess mycobacterium complex group 1240 cases（34.22%），Mycobacterium Kansas 286 cases（7.89%），occasional mycobacteria 285 cases（7.86%），There were 137 cases of Mycobacterium Gordon（3.78%）. The sex ratio of men to women was 1∶139（1 694∶1 930），and the peak age group was 51⁃70 years old（46.36%）. Conclusion In recent years，the detection rate of NTM in Guangzhou has shown an upward trend year by year，the distribution of strains was diverse，the popular strains were mainly stable states of bird⁃intracellular mycobacteria and mycobacterium turtle⁃abscess；middle⁃aged and elderly patients werethe susceptible population，and the female population should be also paid attention to. Finding a more suitable strain identification technology for routine clinical use is the focus of improving accurate diagnosis at present.

Objective To analyze the value of endothelial ⁃specific molecule ⁃ 1（Endocan）and fibrinogen （Fib）levels in the diagnosis and severity assessment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods A total of 79 patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）treated in the department of respiratory and critical care medicine from April 2021 to April 2022 were collected as a AECOPD group. Thegroup was then divided into three subgroups based on disease severity. 30 patients with stable chronic obstructive pulmonary disease（SCOPD）who revisited our clinics during the same period were selected as a SCOPD group，and 30 individuals who underwent physical examination in our hospital were selected as acontrol group. Serum levels ofEndocan and Fib were comparedamong the groups，and the predictive value of the above factors in the diagnosis of AECOPD was analyzed. Results Levels of Endocan and Fib in the AECOPD and SCOPD groups were significantly higher than those in the control group（P < 0.05 for all comparisons），demonstra⁃ tingthe highest levelsin the AECOPD group. Levels of Endocan and Fib were significantly different among the AECO⁃ PD subgroups（P < 0.05），and increased with the severitylevel of AECOPD. The receiver operating characteristic curve analysis results showed that the area under the curve（AUC）of Endocan and Fib were 0.832 and 0.729，respec⁃ tively；and the AUC of the combined detection was higher，which was 0.855. Conclusions The expression levels of serum Endocan and Fib are related to the severity of AECOPD，which can be used as an important indicator for the diagnosis and assessment of disease course. The diagnostic efficiency of Endocan is better thanthat of Fib.

Objective To analyze the efficacy of changes in serum cytokine expression levels in the evalu⁃ ation of pulmonary tuberculosis treatment effects. Methods The serums of pulmonary tuberculosis patients were collected before treatment and after 2⁃month treatment. The expression levels of interleukin（IL）⁃1β，IL⁃2，IL⁃4， IL⁃5，IL⁃6，IL⁃8，IL⁃10，IL⁃12P70，IL⁃17，tumor necrosis factor（TNF）⁃α，interferon（IFN）⁃γ and IFN⁃α were measured by flow cytometry. At the same time，the changes of the lesions were monitored by imaging. The treat⁃ ment was considered as ineffective if the lesions did not change or increased after 2⁃month treatment when com⁃ pared with before treatment，and as effective when the lesions disappeared. Receiver operating curve analysis was done to analyze the cut⁃off value of ratio（ratio of the concentration of each cytokine in serum after 2⁃month treat⁃ ment to that before treatment）and identify the boundary value and test power between the ineffective and effective treatment of pulmonary tuberculosis. After further connecting different cytokines in series or in parallel，the com⁃ bined test performance was analyzed. Results （1）There was no significant difference in age and gender betweenthe ineffective group and the effective group. Overall，the expression levels of IL⁃6 and IFN⁃ γ in the serums of tuberculosis patients after two⁃month treatment were significantly lower than those before treatment（P = 0.020，P = 0.023，respectively）. The expression level of IL⁃10 in the serums after two⁃month treatment was significantly higher than that before treatment（P = 0.011）. After two⁃month treatment，the expression level of IL⁃6 in the serums in the effective group was significantly lower than that before treatment（P = 0.033）.（2）The sensitivity of the ratio of TNF，IL⁃17，IL⁃1β，IL⁃4，IL⁃6，IFN⁃γ，IL⁃12P70，IFN⁃α and IL⁃8 in judging the ineffectiveness of pulmonary tuberculosis treatment was >80%，but the specificity was low. The specificity of the ratio of IL⁃5 and IL⁃10 in judging the ineffectiveness of treatment was >80%，but the sensitivity was low.（3）After combination of IFN⁃ γ，IL⁃17 and IFN⁃ α in series，the sensitivity of judging the ineffectiveness of treatment was 84.00%，the specificity was 70.97%，and the accuracy was 76.79%. After combining the IL⁃6 and IFN⁃α in series，the sensitivi⁃ ty，specificity，and accuracy of judging the ineffectiveness were 80.00% ，67.74% ，and 73.21% ，respectively. Conclusion Compared with before treatment ，the changes in the expression levels of some cytokines in the serums of pulmonary tuberculosis patients after 2⁃month treatment have the potential for monitoring the effect of anti⁃ tuberculosis treatment. 

Objective To explore the efficacy of percutaneous endoscopic posterior lumbar interbody fusion（PE ⁃PLIF）vs minimally invasive transforaminal lumbar interbody fusion（MIS ⁃TLIF）for lumbar canal stenosis. Methods A retrospective analysis of the clinical data of 79 patients with lumbar canal stenosis treated with PE⁃PLIF or MIS⁃TLIF was conducted. Results All patients completed the surgery successfully. The PE⁃PLIF group had fewer hospital days，fewer postoperative bed days，and less intraoperative blood loss than those of the MIS⁃TLIF group，but the total cost and length of surgery were more than those of the MIS⁃TLIF group，with statisti⁃ cally significant differences（P < 0.05）. The visual analogue scale（VAS）of leg pain was lower in the PE⁃PLIF group than that of the MIS⁃TLIF group at 1 week postoperatively，and the VAS score of low back pain was lower in the PE⁃PLIF group than that of the MIS⁃TLIF group at 1 week and 1 and 3 months postoperatively，with a statistically significant difference（P < 0.05）. No statistically significant difference was noted in the postoperative Japanese Orthopedic Association（JOA）score of the lumbar spine，intervertebral space height，sagittal diameter of the spinal canal，efficacy of modified MacNab，and intervertebral fusion between the two groups（P > 0.05）. Conclusion PE⁃PLIF and MIS⁃TLIF had similar short⁃ and medium⁃term clinical efficacy in the treatment of lumbar canal steno⁃ sis，but patients in the PE⁃PLIF group showed better symptomatic improvement than that of the MIS⁃TLIF group at 3 months postoperatively.

Objective To compare the efficacy and safety of fondaparinux sodium with those of enoxaparin sodium in the prevention of pulmonary thromboembolism（PTE）in hospitalized patients in the department of pulmo⁃ nary and critical care medicine（PCCM）. Methods The patients with indicationsofdrug prevention forPTE inthe PCCM of our hospital during the period of May，2020 to June，2021（23 in fondaparinux group and 71 in enoxaparin group）received subcutaneous injections of either 0.5 mL fondaparinux sodium or 0.4 mL enoxaparin sodium for 7 to 12 days. Platelet，D⁃dimer，liver and renal function，and Padua score before and after anti⁃coagulation，the inci⁃ dence of bleeding during anticoagulation and the incidence of PTE within 6 months after discharge in both groups were observed. Results There were no significant differences in platelet，D⁃dimer，liver andrenal function，and Padua score between the two groups before and after anti⁃coagulation（P > 0.05）. There were no significant differ⁃ ences in hospitalization expenses，bleeding incidence（3/23 vs. 10/71）and PTE incidence within 6 months after discharge（5/23 vs. 17/71）between the two groups（P > 0.05）. Level of D⁃dimer after anti⁃coagulation was signifi⁃ cantly lower than the baseline in the two groups（P < 0.001）. As compared with the baselines，there were statisti⁃ cal differences in declined platelet countand increased creatinine levelafter treatment with anti ⁃ coagulation in enoxaparin group（t = 2.858，P = 0.006 and t = -2.400，P = 0.019 respectively），while no significant changes in platelet countand creatinine levelin fondaparinux groupwere found. Conclusions Fondaparinux sodium and enoxa⁃ parin sodium had similar efficacy inthe prevention of PTE. The risk of bleeding during hospitalization and the rate of PTE within 6 months were similar. Fondaparinux sodium had more advantages than enoxaparin sodium in causin⁃ ga decrease in platelet count and an increase in creatinine.

Objective Retention enema is a simple and effective method for preventing and treating radia⁃ tion proctitis（RP），while there is no standard regimen. This study aims to investigate the effectiveness of recombi⁃ nant human epidermal growth factor derivative for external use combined with smectite powder administrated by retention enema for the prevention of RP in cervical cancer patients. Method Fifty⁃nine patients with cervical cancer treated with radical radiotherapy were collected and randomly divided into control group（n = 28）and enema group（n = 31）. The enema group was given recombinant human epidermal growth factor derivative for external use combined with smectite powder by retention enema，while the control group did not receive enema administration. Results Gastrointestinal adverse reaction of the two groups was similar with grade 0⁃2，and there was no statistical difference between two groups（U = 429.5，P = 0.939）in acute PR. In terms of chronic PR，the sub⁃item score and total score of Vienna Rectoscopy Score（VRS）showed that there were more patients with mainly mild adverse events（grade 0 ~ 1）in enema group，while there were significantly more patients with moderate adverse events （grade 2 ~ 3）in the control group. Capillary telangiectasia（U = 262.5，P = 0.003），mucosal hyperemia（U = 256， P = 0.002）and VRS total score（U = 256，P = 0.002）were statistically different in the two groups. Conclusion Recombinant human epidermal growth factor derivative for external use combined with smectite powder administrat⁃ ing by retention enema could reduce the incidence and severity of chronic PR in patients with radical radiotherapy for cervical cancer.

Objective To investigate the correlation between thromboelastograph andendometriosis and its clinical predictive value. Methods A total of 316 patients diagnosed with endometriosis were included in the endometriosis group，and 131 cases of patients diagnosed with other benign ovarian tumors were selected as the control group. The predictive value of the occurrence and development of endometriosis and the correlation of various clinicopathological parameters were evaluated. Results Compared with the control group，the R value and K value of patients in the endometriosis group were decreased，while α Angle，MA value and CI value were increased，the differences were statistically significant（P < 0.05），and R value，α Angle and MA value were independent influ⁃ encing factors for the occurrence of endometriosis（P < 0.01）. The AUC of α Angle was 0.706. The AUC of MA value was 0.730. With the increase of ASRM stage，α Angle and MA value increased（P < 0.01）. The K value of patients with mild pelvic adhesions was higher than those with moderate and severe pelvic adhesions，but the α Angle and MA values were lower，the differences were statistically significant（P < 0.05）. The α Angle and MA values of patients without or partially closed uterine rectum depression were lower than those of patients with com⁃ plete rectum depression，the α Angle，MA and CI values of patients with cysts less than or equal to 5 cm were lower than those of patients with cysts more than 5 cm（P < 0.01）. No significant difference was noted in TEG index between patients with and without dysmenorrhea. Conclusion The changes of TEG indicators were closely related to the occurrence and development of EMs，which could be used as one of the indicators to predict the occurrence and development of EMs. The detection of TEG in patients was helpful for early diagnosis and prognosis discrimina⁃ tion，and provided reference for the evaluation of patients′ condition，the prediction of surgical difficulty and the formulation of treatment plan.

Male fertility has been declining，but the specific factors and mechanisms of male reproductive dysfunction are still unclear. Among the various factors affecting male fertility，oxidative stress（OS）and the damage of male reproductive function caused by inflammatory mediators are the important mechanisms of male infer⁃ tility. Blueberry anthocyanins（BA）is the main active substance extracted from blueberries，which has antioxidant and anti ⁃ inflammatory effects. At a certain dose，it can improve and repair the male reproductive dysfunction caused by the pathological changes through antioxidant and anti⁃inflammatory mechanisms. Therefore，this article reviews the correlation between male reproductive system and OS and inflammatory mediators ，and further expounds the antioxidant and anti ⁃inflammatory mechanisms of BA and its protective effect on male reproductive system，in order to provide an insight into its diagnosis and treatment and build a theoretical basis for treating male reproductive dysfunction patients.